Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 137
Filtrar
1.
Sci Rep ; 14(1): 25680, 2024 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-39465254

RESUMO

Many species exhibit alternative mating tactics (ARTs), with larger socially dominant males competing for females and smaller males adopting "sneaker" strategies to exploit fertilisation opportunities without competition or courtship. Females typically prefer larger socially dominant males, but their ability to manipulate mating or fertilisation outcomes is largely unknown. Here, using chinook salmon Oncorhynchus tshawytscha, we examined whether the female's ovarian fluid (OF) differentially influences the temporal patterns of sperm swimming traits in ejaculates from non-preferred sneaker ('parr') and preferred (dominant) males. Results demonstrate that OF improves sperm swimming speed and linearity compared to river water, regardless of male mating tactic. We report a novel tactic-specific difference in sperm linearity in which parr male sperm initially maintain straighter trajectories in river water, compared to dominant males, but then rapidly change to less linear and more circular paths over time. Intriguingly, we show that OF counteracts this change in sperm linearity in parr males so that patterns become indistinguishable from dominants when parr sperm swim in OF. Together, these results show that male chinook salmon exhibit differential sperm trait investment strategies depending on reproductive tactic.


Assuntos
Salmão , Comportamento Sexual Animal , Espermatozoides , Animais , Masculino , Salmão/fisiologia , Espermatozoides/fisiologia , Comportamento Sexual Animal/fisiologia , Feminino , Motilidade dos Espermatozoides/fisiologia , Reprodução/fisiologia , Rios
2.
Bone Joint J ; 106-B(11): 1306-1311, 2024 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-39481439

RESUMO

Aims: A review of the literature on elbow replacement found no consistency in the clinical outcome measures which are used to assess the effectiveness of interventions. The aim of this study was to define core outcome domains for elbow replacement. Methods: A real-time Delphi survey was conducted over four weeks using outcomes from a scoping review of 362 studies on elbow replacement published between January 1990 and February 2021. A total of 583 outcome descriptors were rationalized to 139 unique outcomes. The survey consisted of 139 outcomes divided into 18 domains. The readability and clarity of the survey was determined by an advisory group including a patient representative. Participants were able to view aggregated responses from other participants in real time and to revisit their responses as many times as they wished during the study period. Participants were able to propose additional items for inclusion. A Patient and Public Inclusion and Engagement (PPIE) panel considered the consensus findings. Results: A total of 45 respondents completed the survey. Nine core mandatory domains were identified: 'return to work or normal daily role'; delivery of care was measured in the domains 'patient satisfaction with the outcome of surgery' and 'would the patient have the same operation again'; 'pain'; 'revision'; 'elbow function'; 'independence in activities of daily living'; 'health-related quality of life'; and 'adverse events'. 'Elbow range of motion' was identified as important by consensus but was felt to be less relevant by the PPIE panel. The PPIE panel unanimously stated that pain should be used as the primary outcome domain. Conclusion: This study defined core domains for the clinical outcomes of elbow replacement obtained by consensus from patients, carers, and healthcare professionals. Pain may be used as the primary outcome in future studies, where appropriate. Further work is required to define the instruments that should be used.


Assuntos
Artroplastia de Substituição do Cotovelo , Técnica Delphi , Satisfação do Paciente , Humanos , Atividades Cotidianas , Qualidade de Vida , Articulação do Cotovelo/cirurgia , Resultado do Tratamento , Avaliação de Resultados em Cuidados de Saúde , Recuperação de Função Fisiológica
3.
Ecol Evol ; 14(5): e11338, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38698926

RESUMO

Gamete traits can vary widely among species, populations and individuals, influencing fertilisation dynamics and overall reproductive fitness. Sexual selection can play an important role in determining the evolution of gamete traits with local environmental conditions determining the strength and direction of sexual selection. Here, we test for signatures of post-mating selection on gamete traits in relation to population density, and possible interactive effects of population density and sperm concentration on sperm motility and fertilisation rates among natural populations of mussels. Our study shows that males from high-density populations produce smaller sperm compared with males from low-density populations, but we detected no effect of population density on egg size. Our results also reveal that females from low-density populations tended to exhibit lower fertilisation rates across a range of sperm concentrations, although this became less important as sperm concentration increased. Variances in fertilisation success were higher for females than males and the effect of gamete compatibility between males and females increases as sperm concentrations increase. These results suggest that local population density can influence gamete traits and fertilisation dynamics but also highlight the importance of phenotypic plasticity in governing sperm-egg interactions in a highly dynamic selective environment.

4.
Perception ; 53(7): 450-464, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38778785

RESUMO

This study aimed to investigate the perception of loudness in response to changes in fundamental frequency (F0) in spoken sounds, as well as the influence of linguistic background on this perceptual process. The results revealed that participants perceived changes in F0 to have accompanying changes in loudness, with a trend of lower F0 sounds being perceived as louder than higher F0 sounds. This finding contrasts with previous studies on pure tones, where increases in frequency typically led to increases in loudness. Furthermore, the study examined differences between two distinct groups of participants: Chinese-speaking and English-speaking individuals. It was observed that English-speaking participants exhibited a greater sensitivity to minor intensity changes compared to Chinese-speaking participants. This discrepancy in sensitivity suggests that linguistic background may play a significant role in shaping the perception of loudness in spoken sound. The study's findings contribute to our understanding of how F0 variations are perceived in terms of loudness, and highlight the potential impact of language experience on this perceptual process.


Assuntos
Percepção Sonora , Percepção da Fala , Humanos , Masculino , Feminino , Percepção Sonora/fisiologia , Adulto , Adulto Jovem , Percepção da Fala/fisiologia , Acústica da Fala , Idioma
6.
Biol Lett ; 19(11): 20230368, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37991195

RESUMO

Sperm ageing after ejaculation can generate paternal environment effects that impact offspring fitness. In many species, female reproductive fluids (FRFs), i.e. ancillary fluids released by eggs or within the female reproductive tract, may protect sperm from ageing and can additionally interact with sperm to influence offspring viability. This raises the intriguing prospect that FRFs may alleviate paternal effects associated with sperm ageing. Here, we test this novel hypothesis using the broadcast spawning mussel, Mytilus galloprovincialis. We show that incubating sperm in FRF prior to fertilization increases offspring viability, and that these effects occur independently of sperm age. Our results provide novel evidence that FRFs allow females to selectively bias fertilization toward higher quality sperm within an ejaculate, which in turn yields more viable offspring. We consider this FRF-mediated paternal effect in the context of female physiological control over fertilization and the transgenerational effects of female-regulated haploid selection.


Assuntos
Fertilizantes , Herança Paterna , Masculino , Feminino , Humanos , Sêmen , Espermatozoides/fisiologia , Reprodução , Fertilização
7.
R Soc Open Sci ; 10(8): 230805, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37650067

RESUMO

Ejaculates can be costly to produce and depend on an individual's condition, defined as the pool of resources allocated to fitness. A method for assessing condition dependence is to manipulate resource availability and test for a reduction in trait expression. Here, we assess the effects of dietary restriction on two determinants of reproductive fitness in the guppy Poecilia reticulata-sperm production and sperm motility. Importantly, we administered dietary restriction at distinct developmental stages to test: (1) whether dietary restriction, when applied exclusively to juveniles, compromised the ejaculates of newly mature males; (2) whether any observed effects of dietary restriction seen in (1) were reversible when fish returned to an unrestricted diet; and (3) whether dietary restriction applied exclusively to adults influenced ejaculates. We found detrimental effects of resource limitation on both traits, and these were consistent across the three developmental stages tested. Furthermore, dietary restriction reduced male body weight, but this was partially reversed when diet-stressed juveniles (i.e. group 2) returned to unrestricted diets. This latter result suggests that diet-stressed males may sacrifice growth in order to maintain their investment in ejaculates. Together these findings underscore the importance of resource acquisition in determining the expression of ejaculate traits.

8.
Proc Biol Sci ; 290(1999): 20230574, 2023 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-37221848

RESUMO

Female reproductive fluids (FRFs) serve key reproductive functions in sexually reproducing animals, including modifying the way sperm swim and detect eggs, and influencing sperm lifespan. Despite the central role of FRF during fertilization, we know surprisingly little about sperm-FRF interactions under different environmental conditions. Theory suggests that in external fertilizers FRF may 'rescue' sperm from ageing effects as they search to fertilize eggs. Here, we test the interaction between these two fundamental properties of the fertilization environment, ejaculate age (i.e. time since ejaculation) and FRF, on a range of functional sperm phenotypes in a broadcast spawning mussel, Mytilus galloprovincialis. We found that the effects of ejaculate age on multivariate sperm motility traits and total sperm motility were altered by FRF, and that longer-lived sperm exhibit stronger, likely more advantageous, responses to FRF after periods of ageing. We also detected significant among-male variation in the relationship between sperm motility traits and ejaculate age; notably, these patterns were only revealed when sperm encountered FRF. Collectively these findings underscore the importance of considering female reproductive physiology when interpreting ageing-related declines in sperm motility, as doing so may expose importance sources of variation in sperm phenotypic plasticity among males and environments.


Assuntos
Fertilizantes , Sêmen , Masculino , Feminino , Animais , Motilidade dos Espermatozoides , Envelhecimento , Hormônio Liberador de Gonadotropina , Espermatozoides , Fenótipo
9.
Plants (Basel) ; 12(4)2023 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-36840072

RESUMO

Rhizomatous growth and associated physiological integration can allow a clonal dune species to potentially compensate for the selective removal of leaves associated with herbivory. Hydrocotyle bonariensis is a rhizomatous clonal plant species that is abundant in the coastal dune environments of the southeastern United States that are inhabited by large feral horse populations. H. bonariensis has been shown to integrate resources among ramets within extensive clones as an adaptation to resource heterogeneity in sandy soils. In this study, we hypothesized that clonal integration is a mechanism that promotes H. bonariensis persistence in these communities, despite high levels of herbivory by feral horses. In a field experiment, we used exclosures to test for herbivory in H. bonariensis over a four-month period. We found that feral horses utilized H. bonariensis as a food species, and that while grazing will suppress clonal biomass, H. bonariensis is able to maintain populations in a high grazing regime with and without competition present. We then conducted an experiment in which portions of H. bonariensis clones were clipped to simulate different levels of grazing. Half of the clones were severed to eliminate the possibility of integration. We found that after 12 weeks, the mean number of leaves and ramets increased as the grazing level increased, for integrated clones. Integrated clones had significantly increased biomass production compared to the severed equivalents. Our research suggests that rhizomatous growth and physiological integration are traits that allow clonal plant species to maintain populations and to tolerate grazing in coastal dune environments.

10.
Trends Biotechnol ; 40(10): 1144-1147, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35902284

RESUMO

Differential sperm chemotaxis describes differences among male-female pairings in chemotactic responses of sperm to egg (or female)-derived chemical attractants. Microfluidic devices provide powerful platforms in which to study this complex gamete interaction. Here, we describe key challenges and potential solutions in applying this state-of-the-art technique to differential sperm chemotaxis.


Assuntos
Quimiotaxia , Dispositivos Lab-On-A-Chip , Quimiotaxia/fisiologia , Feminino , Humanos , Masculino , Sêmen , Espermatozoides/fisiologia
11.
Acta Orthop ; 93: 495-502, 2022 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-35642497

RESUMO

BACKGROUND AND PURPOSE: This study aims to determine, for the first time, generalizable data on the longevity and long-term function of elbow replacements. METHODS: In this systematic review and meta-analysis, we searched MEDLINE and Embase for articles reporting 10-year or greater survival of total elbow replacements (TERs) and distal humeral hemiarthroplasty. Implant survival and patient reported outcome measures (PROMs) data were extracted. National joint replacement registries were also analyzed. We weighted each series and calculated a pooled survival estimate at 10, 15, and 20 years. For PROMs we pooled the standardized mean difference (SMD) at 10 years. FINDINGS: Despite its widespread use, we identified only 9 series reporting all-cause survival of 628 linked TERs and 610 unlinked TERs and no series for distal humeral hemiarthroplasty. The studied population was treated for rheumatoid arthritis in over 90% of cases. The estimated 10-year survival for linked TERs was 92% (95% CI 90-95) and unlinked TERs 84% (CI 81-88). 2 independent registries contributed 32 linked TERs and 530 unlinked TERs. The pooled registry 10-year survival for unlinked TERs was 86% (CI 83-89). Pooled 10-year PROMs from 164 TERs (33 linked and 131 unlinked), revealed a substantial improvement from baseline scores (SMD 2.7 [CI 1.6-3.8]). INTERPRETATION: Over 80% of all elbow replacements and over 90% of linked elbow replacements can last more than 10 years with sustained patient-reported benefits. This information is long overdue and will be particularly useful to patients as well as healthcare providers.


Assuntos
Artroplastia de Substituição , Cotovelo , Seguimentos , Humanos , Sistema de Registros
12.
R Soc Open Sci ; 9(6): 220269, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35706668

RESUMO

There is evidence that animal personality can affect sexual selection, with studies reporting that male behavioural types are associated with success during pre- and post-copulatory sexual selection. Given these links between personality and sexual traits, and the accumulating evidence that their expression can depend on an individual's dietary status (i.e. condition), a novel prediction is that changes in a male's diet should alter both the average expression of personality and sexual traits, and their covariance. We tested these predictions using the guppy Poecilia reticulata, a species previously shown to exhibit strong condition dependence in ejaculate traits and a positive correlation between sperm production and individual variation in boldness. Contrary to expectation, we found that dietary restriction-when administered in mature adult males-did not affect the expression of either behavioural (boldness and activity) or ejaculate traits, although we did find that males subjected to dietary stress exhibited a positive association between sperm velocity and boldness that was not apparent in the unrestricted diet group. This latter finding points to possible context-dependent patterns of covariance between sexually selected traits and personalities, which may have implications for patterns of selection and evolutionary processes under fluctuating environmental conditions.

13.
Bone Joint J ; 104-B(5): 559-566, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35491571

RESUMO

AIMS: Arthroplasty is being increasingly used for the management of distal humeral fractures (DHFs) in elderly patients. Arthroplasty options include total elbow arthroplasty (TEA) and hemiarthroplasty (HA); both have unique complications and there is not yet a consensus on which implant is superior. This systematic review asked: in patients aged over 65 years with unreconstructable DHFs, what differences are there in outcomes, as measured by patient-reported outcome measures (PROMs), range of motion (ROM), and complications, between distal humeral HA and TEA? METHODS: A systematic review of the literature was performed via a search of MEDLINE and Embase. Two reviewers extracted data on PROMs, ROM, and complications. PROMs and ROM results were reported descriptively and a meta-analysis of complications was conducted. Quality of methodology was assessed using Wylde's non-summative four-point system. The study was registered with PROSPERO (CRD42021228329). RESULTS: A total of 29 studies met the inclusion and exclusion criteria. The mean Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) score was 19.6 (SD 7.5) for HA and 38 (SD 11.9) for TEA and the mean abbreviated version of DASH was 17.2 (SD 13.2) for HA and 24.9 (SD 4.8) for TEA. The Mayo Elbow Performance Score was the most commonly reported PROM across included studies, with a mean of 87 (SD 5.3) in HA and 88.3 (SD 5) in TEA. High complication rates were seen in both HA (22% (95% confidence interval (CI) 5 to 44)) and TEA (21% (95% CI 13 to 30), but no statistically significant difference identified. CONCLUSION: This systematic review has indicated PROMs and ROM mostly favouring HA, but with a similarly high complication rate in the two procedures. However, due to the small sample size and heterogeneity between studies, strength of evidence for these findings is low. We propose further research in the form of a national randomized controlled trial. Cite this article: Bone Joint J 2022;104-B(5):559-566.


Assuntos
Artroplastia de Substituição do Cotovelo , Hemiartroplastia , Fraturas do Úmero , Idoso , Cotovelo/cirurgia , Hemiartroplastia/efeitos adversos , Hemiartroplastia/métodos , Humanos , Fraturas do Úmero/cirurgia , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
14.
Biol Lett ; 18(4): 20220042, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35382588

RESUMO

The continued emissions of anthropogenic carbon dioxide are causing progressive ocean acidification (OA). While deleterious effects of OA on biological systems are well documented in the growth of calcifying organisms, lesser studied impacts of OA include potential effects on gamete interactions that determine fertilization, which are likely to influence the many marine species that spawn gametes externally. Here, we explore the effects of OA on the signalling mechanisms that enable sperm to track egg-derived chemicals (sperm chemotaxis). We focus on the mussel Mytilus galloprovincialis, where sperm chemotaxis enables eggs to bias fertilization in favour of genetically compatible males. Using an experimental design based on the North Carolina II factorial breeding design, we test whether the experimental manipulation of seawater pH (comparing ambient conditions to predicted end-of-century scenarios) alters patterns of differential sperm chemotaxis. While we find no evidence that male-female gametic compatibility is impacted by OA, we do find that individual males exhibit consistent variation in how their sperm perform in lowered pH levels. This finding of individual variability in the capacity of ejaculates to respond to chemoattractants under acidified conditions suggests that climate change will exert considerable pressure on male genotypes that can withstand an increasingly hostile fertilization environment.


Assuntos
Mytilus , Água do Mar , Animais , Feminino , Concentração de Íons de Hidrogênio , Masculino , Mytilus/fisiologia , Água do Mar/química , Interações Espermatozoide-Óvulo , Espermatozoides/fisiologia
15.
iScience ; 25(1): 103529, 2022 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-35106458

RESUMO

Invasive species threaten biodiversity and ecosystem functioning. We develop an innovative experimental approach, integrating biologically inspired robotics, time-series analysis, and computer vision, to build a detailed profile of the effects of non-lethal stress on the ecology and evolution of mosquitofish (Gambusia holbrooki)-a global pest. We reveal that brief exposures to a robotic predator alter mosquitofish behavior, increasing fear and stress responses, and mitigate the impact of mosquitofish on native tadpoles (Litoria moorei) in a cause-and-effect fashion. Effects of predation risk from the robot carry over to routine activity and feeding rate of mosquitofish weeks after exposure, resulting in weight loss, variation in body shape, and reduction in the fertility of both sexes-impairing survival, reproduction, and ecological success. We capitalize on evolved responses of mosquitofish to reduce predation risk-neglected in biological control practices-and provide scientific foundations for widespread use of state-of-the-art robotics in ecology and evolution research.

16.
Ecol Evol ; 12(2): e8514, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35154644

RESUMO

Sperm cells exhibit extraordinary phenotypic variation, both among taxa and within individual species, yet our understanding of the adaptive value of sperm trait variation across multiple contexts is incomplete. For species without the opportunity to choose mating partners, such as sessile broadcast spawning invertebrates, fertilization depends on gamete interactions, which in turn can be strongly influenced by local environmental conditions that alter the concentration of sperm and eggs. However, the way in which such environmental factors impact phenotypic selection on functional gamete traits remains unclear in most systems. Here, we analyze patterns of linear and nonlinear multivariate selection under experimentally altered local sperm densities (densities within the capture zone of eggs) on a range of functionally important sperm traits in the broadcast spawning marine mussel, Mytilus galloprovincialis. Specifically, we assay components of sperm motility and morphology across two fertilization environments that simulate either sperm limitation (when there are too few sperm to fertilize all available eggs), or sperm saturation (when there are many more sperm than required for fertilization, and the risk of polyspermy and embryonic failure is heightened). Our findings reveal that the strength, form, and targets of selection on sperm depend on the prevailing fertilization environment. In particular, our analyses revealed multiple significant axes of nonlinear selection on sperm motility traits under sperm limitation, but only significant negative directional selection on flagellum length under sperm saturation. These findings highlight the importance of local sperm densities in driving the adaptation of sperm phenotypes, particularly those related to sperm motility, in broadcast spawning invertebrates.

17.
Knee ; 35: 34-44, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35193031

RESUMO

AIMS: Revision knee replacement is an increasingly common procedure, however, information on patient-focused outcomes is limited. This systematic review and meta-analysis aimed to investigate the medium-term patient reported outcomes following a revision knee replacement. METHODS: We performed a systematic review of MEDLINE and EMBASE (from inception to 1st March 2021) for articles reporting five year or greater patient reported outcome measures (PROMs) following revision knee replacement. A meta-analysis of PROMs data was undertaken using the Standardised Mean Difference (SMD). Quality of methodology was assessed using Wylde's non-summative four-point system. The study was registered with PROPSERO (CRD42021199289). RESULTS: A total of 23 studies met the inclusion criteria containing 2414 patients at a mean minimum follow-up of 74 months (60-122). The reporting of PROMs were poorly standardised with several PROMs being used. The most commonly reported patient reported outcome was the Knee Society Score reported in 65% of studies (15/23). A meta-analysis of 629 eligible patients undergoing revision knee replacement revealed a significant improvement in pre-operative state with a SMD 2·05 95% CI 0.87, 3.23. CONCLUSION: This systematic review has found a significant and sustained improvement in patient-reported outcomes following a revision knee arthroplasty beyond five years. We found a variation in the usage and administration of PROMs which hinders a clear synthesis of results. Furthermore, the PROMs have not been robustly tested for validity in the context of a revision knee replacement.


Assuntos
Artroplastia do Joelho , Artroplastia do Joelho/métodos , Humanos , Articulação do Joelho/cirurgia , Medidas de Resultados Relatados pelo Paciente
18.
Br J Sports Med ; 56(12): 657-666, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35135827

RESUMO

OBJECTIVES: To develop a core outcome set for lateral elbow tendinopathy (COS-LET) and to provide guidance for outcome evaluation in future studies. METHODS: We implemented a multi-stage mixed-methods design combining two systematic reviews, domain mapping of outcome measurement instruments to the core domains of tendinopathy, psychometric analysis of instruments, two patient focus groups and a Delphi study incorporating two surveys and an international consensus meeting. Following the OMERACT guidelines, we used a 70% threshold for consensus. RESULTS: 38 clinicians/researchers and 9 patients participated. 60 instruments were assessed for inclusion. The only instrument that was recommended for the COS-LET was Patient Rated Tennis Elbow Evaluation (PRTEE) for the disability domain. Interim recommendations were made to use: the PRTEE function subscale for the function domain; PRTEE pain subscale items 1, 4 and 5 for the pain over a specified time domain; pain-free grip strength for the physical function capacity domain; a Numerical Rating Scale measuring pain on gripping for the pain on activity/loading domain; and time off work for the participation in life activities domain. No recommendations could be made for the quality-of-life, patient rating of condition and psychological factors domains. CONCLUSIONS: The COS-LET comprises the PRTEE for the disability domain. Interim-use recommendations included PRTEE subscales, time off work, pain-free grip strength and a Numerical Rating Scale measuring pain on gripping. Further work is required to validate these interim measures and develop suitable measures to capture the other domains.


Assuntos
Tendinopatia do Cotovelo , Tendinopatia , Cotovelo de Tenista , Consenso , Tendinopatia do Cotovelo/diagnóstico , Humanos , Avaliação de Resultados em Cuidados de Saúde , Dor , Tendinopatia/diagnóstico , Tendinopatia/psicologia , Cotovelo de Tenista/diagnóstico
19.
Bone Joint J ; 104-B(1): 83-90, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34969289

RESUMO

AIMS: The use and variety of stemless humeral components in anatomical total shoulder arthroplasty (TSA) have proliferated since their advent in 2004. Early outcomes are reassuring but independent mid-term results are scarce. This independent study reports a consecutive series of 143 Eclipse stemless shoulder prostheses with a minimum five-year (5 to 10) follow-up. METHODS: Outcomes of 143 procedures undertaken for all indications in 131 patients were reviewed, with subset analysis of those for osteoarthritis (OA) (n = 99). The primary outcome was the Oxford Shoulder Score (OSS) at a minimum of five years. Secondary outcomes were ranges of motion and radiological analysis of humeral radiolucency, rotator cuff failure, and glenoid loosening. RESULTS: Mean OSS at mean follow-up of 6.67 years (5.0 to 10.74) was 40.12 (9 to 48), with no statistically significant difference between those implanted for a non-OA indication and those for OA (p = 0.056) or time-dependent deterioration between two years and five years (p = 0.206). Ranges of motion significantly improved compared with preoperative findings and were maintained between two and five years with a mean external rotation of 38° (SD 18.1, 0 to 100) and forward elevation of 152° (SD 29.9, 90 to 180). Of those components with radiographs suitable for analysis (n = 83), 23 (28%) were found to have a least one humeral radiolucent line, which were predominantly incomplete, less than 2 mm, and in a single anatomical zone. No humeral components were loose. A radiolucent line was present around 22 (15%) of glenoid components, and 15 (10%) of components had failed. Rotator cuff failure was found in 21 (15%) components. The mean time to either glenoid or rotator cuff failure was greater than three years following implantation. Survivorship was 96.4% (95% CI 91.6 to 98.5, number at risk 128) at five years, and 94.3% (95% CI 88.2 to 97.3, number at risk 76) at seven years, both of which compare favourably with best results taken from available registries. CONCLUSION: Functional and radiological outcomes of the Eclipse stemless TSA are excellent, with no loose humeral components at minimum five-year follow-up. The presence of radiolucent lines is of interest and requires long-term observation but does not impact on the clinical results. Of the eight revisions required, this was predominantly for glenoid and rotator cuff failure. Cite this article: Bone Joint J 2022;104-B(1):83-90.


Assuntos
Artroplastia do Ombro/métodos , Osteoartrite/cirurgia , Prótese de Ombro , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Desenho de Prótese , Falha de Prótese , Amplitude de Movimento Articular , Recuperação de Função Fisiológica
20.
J Orthop Traumatol ; 22(1): 47, 2021 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-34825302

RESUMO

BACKGROUND: Platelet-rich plasma (PRP) is widely used in the management of lateral elbow tendinopathy (LET) despite conflicting evidence on its effectiveness. With high levels of user experience, this study aimed to assess consensus amongst experts on its clinical use. METHODS: A three-round international Delphi study was conducted. Participants were invited through national society mailing lists and contact lists derived from a systematic search of the literature on PRP. In round one, a primary working group developed 40 statements on PRP preparation and clinical application. In rounds two and three, an international group of researchers on PRP and clinical users of the device scored their levels of agreement with the statements on a five-point scale. Consensus was defined as an interquartile range of ≤ 1. RESULTS: Consensus of agreement was only reached for 17/40 (42.5%) statements. For statements on PRP formulation, consensus of agreement was reached in 2/6 statements (33%). Only limited consensus on the contraindications, delivery strategy and delivery technique was achieved. CONCLUSION: Experts reached very limited consensus on the use of PRP in LET. High levels of user experience have not resulted in a convergence of opinion on the technical components of PRP formulation and delivery, substantiating the need for further studies and improved trial reporting.


Assuntos
Tendinopatia do Cotovelo , Doenças Musculoesqueléticas , Plasma Rico em Plaquetas , Tendinopatia , Técnica Delphi , Humanos , Tendinopatia/terapia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA